Building a Healthy Society, Reaching the Last Mile
Strategising with local partners to ensure 100% coverage of Zero –Dose children in missed communities of the Far North Region of Cameroon
“When I first stood at the Makabay Bridge, it dawned on me that the extreme Far North was not only geographically extreme, but it seems it had been abandoned.” Anne, the RAISE for Sahel officer explained how the empty river under the bridge at the entrance into the city of Maroua made her understand how uniquely different the Far North Region was from the rest of Cameroon.
This uniqueness also reflected in its high number of zero-dose children when compared to other parts of the country. With over 12,487 zero-dose children, the Far North Region accounts for 23% of unvaccinated children in Cameroon, hence exposing the population to vaccine-preventable diseases.
Service providers and inhabitants of the Far north have attributed low uptake to the hash climates which can be as hot as 45 degrees Celsius or submerged under water as a results of floats. “Maga, for example, is inaccessible in the rainy seasons as it is situated in the lower basin of the Logone and Chari Rivers. When there is a heavy downpour, Maga sinks underwater.” SEDE, Divisional Officer of Maga, elucidated.
The Far North Region of Cameroon is also characterised by poor road networks. With less than 20 percent of tarred roads linking major towns, inhabitants have to juggle across the bumpy earth roads and sometimes put their lives on the line to cross bridge-less rivers to have access good and Services.
The Boko Haram insurgence in the Far north increased the health burden among other crisis, disrupting the functionality of the Health system, especially at the peripheral levels with acute shortages of staff.
“We have an active reproductive age population and are expected to vaccinate 40% of children in Cameroon. With a depleting workforce covering vast communities who are not always seeking our services, it is unsurprising that we have many zero-dose children in the Region.” said Dr Hamadou Bava Boubakary- Far North Regional Delegate of Public Health.
The presence of migrant and border communities, early marriages, high rates of home deliveries, poverty, ignorance, high level of illiteracy are some of the cultural norms advanced for the limited coverage.
“For the team to successfully penetrate these underserved communities, you need to reinforce strategies to change behaviour patterns acting as impediments to the demand for immunisation services” said Dr Yaya Alhadji Adam, EPI Regional Coordinator, Far North, advised the R4S team.
To better appraise the problem, the RAISE for Sahel Team for the past seven months has been working tirelessly to conduct a desk review and baseline assessment to ensure it produces strategic interventions to reverse the tides and ensure no child is left unimmunised. R4S Team has organised top-notch advocacy meetings and workshops with EPI and other stakeholders in the immunisation landscape at the national and sub-national levels.
The project team has met physically and virtually with health district teams, frontline healthcare workers, vaccinators, community health workers and beneficiaries (parents/gaurdians) in the Far North Region to discuss vaccination uptake, coverage, cold chain equipment and reasons for loss to follow-up. After this granular assessment of the 32 Health Districts in the Far North Region, the team selected five health Districts with the most zero-dose children for its program interventions. These districts include Maga, Maroua 1, Guere, Yagoua and Mora.
Informed, the R4S Team has designed robust strategies tailored to leave no one behind in finding and vaccinating all children in the ZDC communities of the Far North, starting with the Maga Health District. “The Raise for Sahel Project is set to go. We know our terrain, people, and challenges, and our teams are ready to hit the ground running, ” Dr Foyeth R4S Project Manager, reassured with much optimism.
The Far North Region is one of the three regions in Cameroon where the R4S Zero Dose Immunisation Project (ZIP) will implement its 18-month interventions in 9 Health Districts. Other regions include the Northwest and south-west regions.